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Gov. Matt Bevin said Monday despite praise for Kentucky’s embrace of the Affordable Care Act in recent years, the initiative has been an “abject failure” in the state.

“Kentucky, which has long been vaunted as an example of the opposite, I’m telling you as a matter of fact has been an unmitigated disaster,” Bevin said at a news conference after governors attended an event with President Trump.

Bevin has long opposed the Affordable Care Act, which made more people eligible for Medicaid in Kentucky and created a state exchange, Kynect, for people to purchase health insurance.

Mike Caudill runs Mountain Comprehensive Care Corporation in five eastern Kentucky counties. Many of his 30,000 patients gained insurance through Medicaid expansion under the Affordable Care Act. No one knows if or when those folks might lose coverage. But, Caudill said, the impact could be considerable.

“I don’t want to be a Chicken Little that the sky is falling. On the other hand, neither do I want to stick my head in the sand,” he said. “A lot of it is the unknown. We don’t know what is going to happen.”

Caudill runs federally qualified health centers, providing primary and preventive care such as doctor’s visits and vaccinations. They also support community programs including a day care and a service providing fresh fruits and vegetables to 700 people who are chronically ill. If there are significant changes in his revenue because of a repeal of the ACA, Caudill said, those programs that improve the quality of life in the community would be the first to go.

Kentucky’s state auditor has released a report detailing problems with last year’s rollout of Benefind, the new online portal for state benefits like health care, food stamps and cash assistance.

Both the administrations of Gov. Matt Bevin, who took office nearly three months before the rollout, and that of former Gov. Steve Beshear, which spearheaded the development of the new system, had identified problems with Benefind before its introduction.

Dona Wells walked through what’s left of the EMW Women’s Clinic in Lexington, Kentucky. Boxes fill what use to be offices. Sterilized medical supplies are in disarray. A light flickers on and off in the back hallway. She doesn’t see a point in fixing it. At 75, she still runs 25 miles a week, but Wells is tired.

“I was going to retire anyway, probably this year,” she said. But I wanted to do it on my terms, not Gov. Bevin’s terms.”

That would be Kentucky Gov. Matt Bevin, who recently signed two bills into law further restricting abortion services: one requiring an ultrasound as part of abortions and another prohibiting the procedure after 20 weeks of pregnancy. The final straw for Wells came in the form of a new license requirement from the state. Wells has been battling restrictive rules for most of the clinic’s 28 years, but the battle is over now. She’s closing the clinic.

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3:59

Hear Mary's story about the declining availability of abortion services in our region.

She asked to not be identified. And it’s understandable given the stigma attached to addiction. For this story, we’ll call her “Mary.”

Mary lives in eastern Kentucky and has struggled with an addiction that began with painkillers and progressed to heroin.

“As soon as I opened my eyes, I had to get it,” Mary said. “And even when I did get it, then I had to think of the next way that I was going to get.”

Mary was using when she learned she was pregnant with her first child. She sought treatment but the disease had a tight grip on her.

The child was born dependent on opioids and went through the pains of withdrawal shortly after delivery.

“To see that little boy go through that stuff, you’d think that I would, like, change my life around immediately but I didn’t,” Mary said. “I didn’t want to believe it. I was in complete denial that because of my choices, it was my fault that he was going through that.”

As Congress weighs repeal of the Affordable Care Act, the home state of Vice President Mike Pence Tuesday sought to keep its conservative-style Medicaid expansion under the federal health the health law.

On any given day in Martin County, Kentucky, the water system loses more water to leaks than it delivers to paying customers through their faucets. The water system is under a state investigation for the third time since 2002. Customers complain of frequent service interruptions and discolored water, and their bills come with a notice that drinking the water could increase the risk of cancer.

This is the state of infrastructure in a county that’s mined many millions of dollars worth of coal since the early 1900s, providing the power required for America’s industries and modern comforts. As with many coalfield communities, all the profit and advances the area’s laborers and natural resources made possible haven’t left much evidence of improvement in the local economy and infrastructure.

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3:51

Hear Benny's piece on the impact dirty drinking water is having on Martin County, Ky.

Kentucky Sen. Rand Paul introduced a bill to repeal and replace the Affordable Care Act on Wednesday that would do away with the law’s major reforms, including the requirement to have health insurance or pay a penalty and the ban on insurers refusing coverage for those with pre-existing conditions.

Under the proposal, people wouldn’t be required to get health insurance, nor would employers be required to offer it. Instead, groups of people and small employers could come together to form “independent health pools” to negotiate rates.

Humana and Aetna won’t be allowed to merge, according to a ruling from a federal judge out on Monday. Antitrust and competition issues were cited.

The companies will likely appeal the ruling, handed down from Washington, D.C. District Court Judge John Bates. An appeal could take another six months to a year.

Tom Noland, spokesperson for Humana, said the company was prepared for this outcome and is still reviewing the 153-page decision. He also noted that whatever the final outcome, Humana will continue as a company.

“The fact that we have millions of members, most of whom renew every year, shows that we do great work,” Noland said.

A recent report from the Centers for Disease Control offers a stark example of the declining power of medicine’s most important weapons against infectious disease. The CDC noted that a patient who died at a Nevada hospital last year had an infection that was resistant to 26 different antibiotic treatments. That’s essentially the entire antibiotic arsenal doctors had.

There’s an antibiotic problem in the U.S. Some just aren’t working anymore as resistant bacteria, so-called “superbugs,” are growing. Part of the problem lies with farms, where massive amounts of antibiotics have been used on livestock, including animals that aren’t even sick.

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3:53

Hear Part one of Nicole and Lisa's story about superbugs and antibiotic resistance.

At about 1:30 a.m. on Thursday, Republicans moved one step closer to repealing a law they have railed against since the moment it was passed nearly seven years ago.

By a final vote of 51-48, the Senate approved a budget resolution that sets the stage for broad swaths of the Affordable Care Act to be repealed through a process known as budget reconciliation. The resolution now goes to the House, where leaders are hoping to approve it by the end of the week.

The powerful tool sets up a fast track for repealing large parts of Barack Obama's major domestic achievement; the best guess is that the Senate is still several weeks away from largely repealing Obamacare. But as the process continues, large questions still loom over how — and when – Republicans will replace the healthcare law.

Whether health insurers Aetna and Humana can merge will likely soon be decided, and the outcome might just have an impact on the price you pay at the doctor’s office.

A new study from researchers at Harvard shows what could happen to the amount policyholders have to pay for a doctor’s visit.

The findings, published in Health Affairs, show that the lower prices consumers pay shopping wholesale — for example, at Costco — also apply to health care. Insurance companies with more buying power – through having more policyholders – pay lower prices for health care services. For instance, insurers with more than 15 percent of a market population paid the least amount for an office visit: $70. That increased to $88 for an insurer with less than 5 percent of marketshare.

The outcome of the repeal-and-replace Obamacare debate could affect more than you might think, depending on just how the GOP congressional majority pursues its goal.

Beyond the Affordable Care Act's marquee achievements like guaranteeing health coverage for people with pre-existing conditions and allowing children to stay on parents' plans until age 26, the roughly 2,000-page law created a host of other provisions that affect the health of nearly every American.

Some of these measures are evident every day. Some enjoy broad support, even though people often don't always realize they spring from the statute.

Health officials in Lexington and Louisville are urging people who haven't gotten flu shots to get vaccinated.

A statement from the Lexington-Fayette County Health Department says two recent flu-related deaths have been reported. In Louisville, health officials are reported a spike in the number of flu cases. Both agencies sent an appeal urging people to get vaccinated as flu season ramps up. It typically peaks in late January or early February.

In Fayette County, officials say there have been at least 13 confirmed cases of the flu. In Louisville, officials say there have been 20 cases confirmed in less than two weeks compared to eight cases in the preceding seven weeks.

Kentucky Sen. Rand Paul said Wednesday that he would not vote to repeal the Affordable Care Act, known to many as Obamacare, without voting for a replacement plan on the same day. He made the comments on MSNBC’s “Morning Joe.”

“Here’s the great irony, this week we’re going to vote on a budget,” he said. “Everybody is hot and heavy to vote on this budget because they want to repeal Obamacare. But the budget they’re going to introduce will add $8.8 trillion to the debt over the next 10 years. So I told them look, I’m not going to vote for a budget that never balances.”